TY - JOUR
T1 - Prevalence, associated factors and outcomes of pressure injuries in adult intensive care unit patients
T2 - the DecubICUs study
AU - DecubICUs Study Team
AU - Labeau, Sonia O
AU - Afonso, Elsa
AU - Benbenishty, Julie
AU - Blackwood, Bronagh
AU - Boulanger, Carole
AU - Brett, Stephen J
AU - Calvino-Gunther, Silvia
AU - Chaboyer, Wendy
AU - Coyer, Fiona
AU - Deschepper, Mieke
AU - François, Guy
AU - Honore, Patrick M
AU - Jankovic, Radmilo
AU - Khanna, Ashish K
AU - Llaurado-Serra, Mireia
AU - Lin, Frances
AU - Rose, Louise
AU - Rubulotta, Francesca
AU - Michigan, Department of Anesthesiology University
AU - Williams, Ged
AU - Blot, Stijn I
AU - Dieperink, Willem
PY - 2020/10
Y1 - 2020/10
N2 - PURPOSE: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients.METHODS: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis.RESULTS: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9-27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6-16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score < 19, ICU stay > 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2-1.8), stage II (OR 1.6; 95% CI 1.4-1.9), and stage III or worse (OR 2.8; 95% CI 2.3-3.3).CONCLUSION: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat.A correction on this original article is published in February 2021.
AB - PURPOSE: Intensive care unit (ICU) patients are particularly susceptible to developing pressure injuries. Epidemiologic data is however unavailable. We aimed to provide an international picture of the extent of pressure injuries and factors associated with ICU-acquired pressure injuries in adult ICU patients.METHODS: International 1-day point-prevalence study; follow-up for outcome assessment until hospital discharge (maximum 12 weeks). Factors associated with ICU-acquired pressure injury and hospital mortality were assessed by generalised linear mixed-effects regression analysis.RESULTS: Data from 13,254 patients in 1117 ICUs (90 countries) revealed 6747 pressure injuries; 3997 (59.2%) were ICU-acquired. Overall prevalence was 26.6% (95% confidence interval [CI] 25.9-27.3). ICU-acquired prevalence was 16.2% (95% CI 15.6-16.8). Sacrum (37%) and heels (19.5%) were most affected. Factors independently associated with ICU-acquired pressure injuries were older age, male sex, being underweight, emergency surgery, higher Simplified Acute Physiology Score II, Braden score < 19, ICU stay > 3 days, comorbidities (chronic obstructive pulmonary disease, immunodeficiency), organ support (renal replacement, mechanical ventilation on ICU admission), and being in a low or lower-middle income-economy. Gradually increasing associations with mortality were identified for increasing severity of pressure injury: stage I (odds ratio [OR] 1.5; 95% CI 1.2-1.8), stage II (OR 1.6; 95% CI 1.4-1.9), and stage III or worse (OR 2.8; 95% CI 2.3-3.3).CONCLUSION: Pressure injuries are common in adult ICU patients. ICU-acquired pressure injuries are associated with mainly intrinsic factors and mortality. Optimal care standards, increased awareness, appropriate resource allocation, and further research into optimal prevention are pivotal to tackle this important patient safety threat.A correction on this original article is published in February 2021.
KW - adults
KW - aged
KW - hospital mortality
KW - pressure injuries
KW - intensive care units
KW - male
KW - patient discharge
KW - prevalence
KW - respiration, artificial
KW - risk factors
KW - decubitus
KW - intensive care
KW - volwassenen
KW - prevalentie
KW - intensive care units
KW - ouderen
KW - mannen
KW - kunstmatige ademhaling
KW - risicofactoren
KW - ziekenhuissterfte
U2 - 10.1007/s00134-020-06234-9
DO - 10.1007/s00134-020-06234-9
M3 - Article
C2 - 33034686
SN - 0342-4642
VL - 47
SP - 160
EP - 169
JO - Intensive Care Medicine
JF - Intensive Care Medicine
IS - 2
ER -